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P81 Exploring gendered patterns of cancer in Chile: Focus on universal coverage and international migration
  1. M Oyarte1,
  2. V Pedrero1,
  3. B Cabieses1,2
  1. 1Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
  2. 2Department of Health Sciences, University of York, York, UK

Abstract

Background Immigration to Chile has grown in recent decades, reaching 2.7% total population in 2014. The Chilean healthcare system is mixed (public and private) but guarantees universal coverage (prevention/diagnosis/treatment) to its beneficiary population for over 80 different prioritised pathologies. This includes the diagnosis and treatment of breast and male genital cancer (largely prostate cancer). Around 8.9% of immigrants in Chile have no healthcare insurance and there are no studies on cancer and migration status in Chile. The purpose of this study was to explore the differences in prevalence rates from breast and male genital cancer, based on national hospital discharge (HDs) records, between the Chilean-born and the international migrant populations in 2012.

Methods Prevalence study, based on HDs for all cancers in Chile in 2012 (N = 74.768). Prevalence rates of breast and male genital cancers were compared between the Chilean-born and the international migrant populations, crude and adjusted by relevant demographic (age groups/sex/region/healthcare prevision) and clinical variables (type of cancer/type of treatment/outcome: alive/death).

Results Based on HDs, there was 7.728 HDs caused by breast cancer and 5.711 caused by male genital cancer in 2012. Among immigrants, 5.8% of HD in 2012 in Chile were caused by cancer. From these, 16.7% and 3.5% were caused by breast and male genital organs cancers, respectively (versus 10.3% and 7.7% in the Chilean-born). In the case of breast cancer HDs, 63% of all immigrant cases corresponded to women assigned to the private healthcare system, whereas a 47% of HDs for male genital cancer among immigrant men belonged to cases with no healthcare insurance. This was significantly different to the local population, in which for both types of cancer more than 65% of the cases corresponded to events affiliated to the public healthcare system. 72% of breast cancer cases in the Chilean-born required surgery, while only 46% of breast cancer cases required surgical intervention among immigrants. Besides, 76% of the HDs from male genital cancer had surgery among immigrants compared to only 49% of surgical interventions that happened among the Chilean-born. The prevalence of age at diagnosis and death were similar for both types of cancer between comparison groups.

Conclusion The prevalence rate of breast cancer was higher in the immigrant population compared to the Chilean-born. Most events for the Chilean-born belonged to the public healthcare system, whereas most events in the migrant population belonged to the private insurance or no healthcare provision.

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